Internal medicine paging curriculum to improve physician-nurse interprofessional communication: a single center pilot study

ABSTRACT

Effective physician-nurse communication is critical to patient safety, yet internal medicine trainees are rarely given feedback on this skill. In order to address this gap, we developed a 4-week simulated paging curriculum for senior medical students. Standardized Registered Nurses administered five acute inpatient paging cases to students via telephone and scored communication on a 10-point global scale (1 = highly ineffective to 10 = highly effective) and seven communication domains using a 5-point Likert-type scale. The domains included precision/clarity, instructive, directing, assertive, ability to solicit information, engaged, and structured communication. Students received verbal and written feedback from the nurses on communication skills and clinical decision-making. Our primary goal was to determine if student-nurse communication improved throughout the curriculum. Data were analyzed using multivariate ANOVAs with repeated measures. Twenty-seven students participated. Global communication scores increased significantly from case 1 to case 5 (7.1 to 8.7, p < .01). The following communication domains increased significantly: precision (3.8 to 4.4, p < .01), instructive (3.6 to 4.7, p < .01), directing (4.0 to 4.6, p = .02), assertiveness (4.0 to 4.7, p = .04), engaged (4.1 to 4.7, p < .01). In conclusion, this curriculum can be an innovative approach to improve physician-nurse communication using standardized registered nurses to deliver structured feedback to medical trainees.

KEYWORDS:

• Interprofessional education
• communication

Acknowledgments

Amanda Stricklen, MS, RN, Rachel Ross MS, RN

Declaration of interest

None of the authors have disclosures

Supplementary Material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Notes on contributors

Lauren A. Heidemann

Lauren A. Heidemann is an assistant professor, Department of Internal Medicine at University of Michigan Medical School. She is the Director of the Internal Medicine Residency Preparation Course.

Samantha Kempner

Samantha Kempner is an assistant professor, Departments of Obstetrics and Gynecology at University of Michigan Medical School. She is Director of the Simulated Paging Curriculum for the Residency Preparation Courses.

Eric Walford

Eric Walford is an assistant professor, Department of Internal Medicine at University of Michigan Medical School. He is the co-director of the Internal Medicine Residency Preparation Course.

Ryan Chippendale

Ryan Chippendale is an assistant professor, Department of Internal Medicine at Boston University School of Medicine. She is the Director of the Internal Medicine Boot Camp Course.

James T. Fitzgerald

James T. Fitzgerald is a professor, Department of Learning Health Sciences, University of Michigan Medical School. He currently directs the assessment component in the University of Michigan Medical School’s competency-based Master in Health Professions Education program.

Helen K. Morgan

Helen K. Morgan is an associate professor, Departments of Obstetrics and Gynecology and Learning Health Sciences, University of Michigan Medical School. She is the Director of the Residency Preparation Courses.